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- Ziaei, Shirin, et al.
(författare)
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Women´s autonomy and social support and their associations with infant and young child feeding and nutritional status : community-based survey in rural Nicaragua
- 2015
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 18:11, s. 1979-1990
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo evaluate the associations of women’s autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua.DesignCross-sectional study. Feeding practices and children’s nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women’s autonomy was assessed by a seventeen-item questionnaire covering dimensions of financial independence, household-, child-, reproductive and health-related decision making and freedom of movement. Women’s social support was determined using the Duke-UNC Functional Social Support Questionnaire. The scores attained were categorized into tertiles.SettingLos Cuatro Santos area, rural Nicaragua.Subjects A total of 1371 children 0–35 months of age.ResultsChildren of women with the lowest autonomy were more likely to be exclusively breast-fed and continue to be breast-fed, while children of women with middle level of autonomy had better complementary feeding practices. Children of women with the lowest social support were more likely to consume highly processed snacks and/or sugar-sweetened beverages but also be taller.ConclusionsWhile lower levels of autonomy and social support were independently associated with some favourable feeding and nutrition outcomes, this may not indicate a causal relationship but rather that these factors reflect other matters of importance for child care.
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| 2. |
- Ziaei, Shirin
(författare)
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Women’s status and child nutrition : Findings from community studies in Bangladesh and Nicaragua
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The importance of women’s status for child nutrition has recently been recognized. However, pathways through which women’s status can affect their caretaking practices and child nutrition have not been fully determined. The aim of this thesis was to evaluate associations between aspects of women’s status – including exposure to domestic violence and level of autonomy and social support – with their level of stress, feeding practices and child nutritional status in two different cultural settings: Bangladesh and Nicaragua.Data were acquired from population-based studies. For Study I we used data from the Bangladesh 2007 Demographic and Health Survey, and Study II was embedded in the 2009 Health and Demographic Surveillance System conducted in Los Cuatro Santos, rural Nicaragua. Studies III and IV were part of the MINIMat study, conducted in rural Bangladesh. In-person interviews were conducted and validated questionnaires were used in each of the studies. Anthropometric characteristics of the children were recorded based on standardized World Health Organization techniques.In Bangladesh, we found women with lifetime experience of domestic violence to be more likely to report emotional distress during pregnancy, cease exclusive breastfeeding before 6 months and have a stunted child. Further, we found a negative association between experience of domestic violence and duration of excusive breastfeeding to be mitigated with breastfeeding counseling. In Nicaragua, a lower level of maternal autonomy was associated with more appropriate breastfeeding practices such as higher odds of exclusive breastfeeding and longer continuation of breastfeeding. Further, a maternal lower level of social support was associated with better child nutritional status.In conclusion, this investigation showed that different dimensions of women’s status were associated with their feeding practices and child nutritional status and also revealed that the strength and direction of these associations may vary by the child’s age, setting and other contextual factors. These findings suggest that women’s status might have an important public health impact on child health and its role should be considered in programs and policies aiming to improve child health and nutrition.
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| 5. |
- Contreras, Mariela, 1979-
(författare)
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Child nutrition in rural Nicaragua : Population-based studies in a transitional society
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Emerging favourable as well as unfavourable nutrition patterns are observed in societies undergoing rapid social and economic change. The aim of this thesis is to analyse the associations between household and maternal resources and infant and young child feeding habits and nutritional status in rural Nicaragua, a low-income transitional society.All households (n=1,500) in Los Cuatro Santos with at least one child (0-3 y) were visited to collect information on feeding of the youngest child. Children´s anthropometry was also measured using standardised World Health Organisation (WHO) techniques. Validated instruments were used to assess household and maternal resources. All instruments had been adapted to the local context and piloted in a nearby community. The education of the mother showed more independent variation in the studied outcomes. The odds for exclusive breastfeeding were highest in infants aged 0 to 5 months of mothers with the lowest education. Further, children aged 6 to 35 months with lowest educated mothers were less likely to consume highly processed snacks (HP snacks) and sugar-sweetened beverages (SSBs). They were also less likely to be exposed to a double burden of suboptimal feeding (concurrent unmet WHO recommended feeding practices and consumption of HP snacks or SSBs). However, children aged 6 to 35 months were more prone to infrequently meet dietary diversity and to more shortness. Children in the same age group with lower educated mothers were also shorter in households with the lowest housing quality.Higher level of maternal education contributed both favourably and unfavourably to child feeding and nutrition. This was reflected in more and less frequent practice of the WHO feeding indicators, but also in more frequent children´s consumption of HP snacks and SSBs. Higher maternal education was associated with taller children, even in households with the lowest housing quality.
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| 6. |
- Ziaei, Shirin, et al.
(författare)
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A Prenatal Multiple Micronutrient Supplement Produces Higher Maternal Vitamin B-12 Concentrations and Similar Folate, Ferritin, and Zinc Concentrations as the Standard 60-mg Iron Plus 400-μg Folic Acid Supplement in Rural Bangladeshi Women.
- 2016
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Ingår i: Journal of Nutrition. - : Elsevier BV. - 0022-3166 .- 1541-6100. ; 146:12, s. 2520-2529
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The effects of prenatal food and micronutrient supplementation on maternal micronutrient status are not well known.OBJECTIVE: We compared the efficacy and effectiveness of 3 different micronutrient supplements on maternal micronutrient status when combined with food supplementation.METHODS: In the MINIMat (Maternal and Infant Nutrition Intervention, Matlab) trial in Bangladesh, 4436 pregnant women were randomly assigned to daily intake of 3 types of micronutrient capsules: 30 mg Fe and 400 μg folic acid (Fe30F), 60 mg Fe and 400 μg folic acid (Fe60F), or multiple micronutrient supplements (MMNs) combined with early (week 9 of pregnancy) or usual (week 20 of pregnancy) food supplementation in a 2 by 3 factorial design. Plasma concentrations of vitamin B-12, folate, ferritin, and zinc were analyzed before the start of micronutrient supplementation (week 14) and at week 30 of pregnancy in 641 randomly selected women. An electronic monitoring device was used to measure the number of capsules taken. The effectiveness of food and micronutrient regimens as well as efficacy per capsule in maternal micronutrient status were analyzed by ANOVA and general linear models.RESULTS: At week 30 of pregnancy, women in the MMN group had higher geometric mean concentrations of vitamin B-12 than women in the Fe60F group (119 compared with 101 pmol/L, respectively); no other differences in effectiveness of micronutrient and food regimens were observed. A dose-response relation between the number of capsules taken and concentrations of folate and ferritin was observed for all micronutrient supplements. Fe30F had lower efficacy per capsule in increasing ferritin concentrations within the first tertile of capsule intake than did Fe60F and MMNs. Because ferritin reached a plateau for all types of micronutrient supplements, there was no difference between the regimens in their effectiveness.CONCLUSION: Compared with Fe60F, MMNs produced higher maternal vitamin B-12 and similar ferritin and folate concentrations in Bangladeshi women. The MINIMat trial was registered at isrctn.org as ISRCTN16581394.
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| 8. |
- Contreras, Mariela, 1979-, et al.
(författare)
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Socio-economic resources, young child feeding practices, consumption of highly processed snacks and sugar-sweetened beverages : a population-based survey in rural northwestern Nicaragua
- 2015
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Socio-economic resources may be associated with infant feeding in complex patterns in societies undergoing a nutrition transition. This study evaluates associations of housing quality, food security and maternal education to the World Health Organization (WHO) feeding recommendations and to consumption of highly processed snacks (HP snacks) and sugar-sweetened beverages (SSBs) in rural Nicaragua. Methods: Data were collected from May to November 2009, with mothers of 0- to 35-month-olds being asked about young child feeding using a food frequency questionnaire. A validated questionnaire was used to assess household food insecurity and data were collected on maternal education and housing quality. Pearson's chi-squared test was used to compare proportions and determine associations between the resources and young child feeding. The three socio-economic resources and other confounders were introduced to multivariate logistic regression analyses to assess the independent contribution of the resources to the feeding practices and consumption of HP snacks and SSBs. Results: Mothers with the lowest education level were more likely to be exclusively breastfeeding (EBF) their infants (OR not EBF: 0.19; 95% CI: 0.07, 0.51), whilst mothers of 6- to 35-month-olds in the lowest education category had more inadequate dietary diversity (DD) (OR for not meet DD: 2.04; 95% CI: 1.36, 3.08), were less likely to consume HP snacks (OR for HP snacks: 0.47; 95% CI: 0.32, 0.68) and SSBs (OR for SSBs: 0.68; 95% CI: 0.46, 0.98), compared to mothers with the highest level of education. Similarly, children residing in households with the highest food insecurity were also more prone to have inadequate dietary diversity (OR for not meet DD: 1.47; 95% CI: 1.05, 2.05). The odds for double burden of suboptimal feeding (concurrent inadequate diet and consumption of HP snacks/SSBs) were significantly lower in children of least educated mothers (OR: 0.64; 95% CI: 0.44, 0.92). Conclusions: Higher level of education was associated with both more and less adherence to the WHO recommended feeding practices as well as with more consumption of HP snacks and SSBs. Regardless of educational strata, the children in the community were exposed to suboptimal feeding practices conducive to both under-as well as overnutrition.
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| 10. |
- Contreras, Mariela, 1979-, et al.
(författare)
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Consumption of highly processed snacks, sugar-sweetened beverages and child feeding practices in a rural area of Nicaragua
- 2016
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 12:1, s. 164-176
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Tidskriftsartikel (refereegranskat)abstract
- Appropriate feeding behaviours are important for child growth and development. In societies undergoing nutrition transition, new food items are introduced that may be unfavourable for child health. Set in rural Nicaragua, the aim of this study was to describe the infant and young child feeding (IYCF) practices as well as the consumption of highly processed snack foods (HP snacks) and sugar-sweetened beverages (SSBs). All households with at least one child 0- to 35-month-old (n = 1371) were visited to collect information on current IYCF practices in the youngest child as well as consumption of SSBs and HP snacks. Breastfeeding was dominant (98%) among 0- to 1-month-olds and continued to be prevalent (60%) in the second year, while only 34% of the 0- to 5-month-olds were exclusively breastfed. Complementary feeding practices were deemed acceptable for only 59% of the 6- to 11-month-old infants, with low dietary diversity reported for 50% and inadequate meal frequency reported for 30%. Consumption of HP snacks and SSBs was frequent and started early; among 6- to 8-month-olds, 42% and 32% had consumed HP snacks and SSBs, respectively. The difference between the observed IYCF behaviours and World Health Organization recommendations raises concern of increased risk of infections and insufficient intake of micronutrients that may impair linear growth. The concurrent high consumption of SSBs and HP snacks may increase the risk of displacing the recommended feeding behaviours. To promote immediate and long-term health, growth and development, there is a need to both promote recommended IYCF practices as well as discourage unfavourable feeding behaviours.
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